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Kiribati ‐ Food and Nutrition Security Profiles Key Indicators •Dietary Energy Supply (DES) is high, but related to increased oils, sugar and carbohydrates. Dietary diversity is poor, with low levels of protein and vitamins. •Overweight in adulthood represents a very significant public health problem, with 81.5% of people overweight Figure 1.2 Undernourishment and Economic Growth From 1990 to ‐2012: • GDP increased 22% • Undernourishment decreased 16% GDP per person, PPP (constant 2011 dollars) Undernourished in total population 7.6 7 378 1500 1500 2645 Source: GDP: WDI 2014 / Undernourished: FAO FSI_2013 Figure 1.3 Child Malnutrition 2012 2010 2008 2006 2004 2002 2000 1998 1996 1994 5 1992 1300 1990 48.2 24.1 22.2 Infant 6 2000 53.6 Neonatal Under fives Figure 1.5 Anaemia • Anaemia is a serious public health issue, high among pregnant women (38%) and non‐pregnant women (31%) and severe among under‐5 children (42%) • Deworming and iron supplementation can be effective for reducing anaemia in pregnant women as well as children. Total <2 yr Children <5 years 2301 21.6 Source: Inter‐agency Group for CME (2013) 42 Non ‐ pregnant women of reproductive age 1000 46.3 28.7 1453 286 Kcal per person per day 2500 8 59.9 2015 3022 3000 62.8 2012 1700 MDG Target 31 68.2 2010 1772 9 71.1 2005 3500 94.1 2000 Percent 10 1995 International $ 1900 9.1 2587 Figure 1.4 Child Mortality From 1990 to 2010: • Under‐5 mortality reduced 36% and will not achieve the Millennium Development Goal (MDG) target • Infant mortality reduced 35% • Neonatal mortality reduced 25% 1990 Figure 1.1 Food Availability From 1990 to 2011: •DES increased 17% •Animal‐origin supply increased 32% •Vegetal‐origin products increased 15% and remained the major DES source 31 Pregnant women 38 0 500 20 40 60 80 Prevalence of Anaemia (%) 100 Source: WHO Worldwide prevalence of Anaemia (1993‐2005) Anthropometry (Table 1.1) 0 1990 2011 Animal Origin Vegetal Origin Total Dietary Energy Supply (DES) Source : FAOSTAT FBS: 2014 update No Data Underweight women (BMI < 18.5 kg/m2) 0.6 % 2006 ‐ ‐ Overweight adults (BMI >= 25 kg/m2) * BMI values calculated using adult cut off points, population < 20 should be analyzed using WHO growth reference for school aged children and adolescents Proportion of infants with low birth weight Source: 5 % WHO Global Database on BMI & SOWC2014 1998 Kiribati ‐ Food and Nutrition Security Profiles Food Availability / Food Access Access to food Figure 2.2 Economic access to food General and food inflation Percent General inflation Food inflation 25 19 20 15 Food Availability 10 Figure 2.1 Food supply by food group 5 2008 2007 2006 2005 2004 2003 2002 1990 ‐5 986 873 Cereals ‐10 596 528 Rice 0 2000 2011 0 2001 (kcal/person/year) Total dietary energy supply= 3,022 (2011) Source: LABORSTA Labour Statistics Database, ILO (2013) 390 344 Wheat • In 2008, food prices increased considerably (19%), followed by a significant increase in general inflation (12%) •In 2009, only 31% of dietary food consumption was comprised of cereals 206 141 Meat & Milk & Eggs 469 Sugars and syrups 298 152 128 Fruits & vegetables 747 Vegetable oils 180 151 134 Fish & Fish products Animal fats 19 Pulses 18 12 Figure 2.3 Share of food expenditure 0 100 255 Starchy roots Non food items 263 0 (2009) 400 800 1,200 Source: UN_FAO Food Balance Sheets_2014 Update Percent • Cereals are the most important source of food energy (33 %). Altogether, carbohydrates in the form of cereals and starchy roots contribute 41% of DES Nevertheless Vegetable oils and Oilcrops have increased significantly and contribute to the 25% of the total DES. • Sugars and syrups continued to be a significant contributor (16%) of DES also, while meat, milk and eggs comprised 7% Cereals 31 Fruits and vegetables 5 80 60 5 Fish 14 Sugars 5 40 8 Veg oils 20 Meat, milk and eggs 33 Other 0 % Total expenditure per person per day % Dietry energy Consumption Source: * FBS (2000) and ** 2000 Family Income and Expenditures Survey, NSO, , Kiribati Kiribati ‐ Food and Nutrition Security Profiles Food Utilization Food utilization refers both to household preparation practices of foods, which influence nutrient content of consumed foods, and to the absorption of nutrients by the human body after consumption. Nutrient absorption in the gut is strongly influenced by health status, particularly the presence of diarrhoea. Hygienic environmental conditions related to improved water and sanitation are important determinants of health and infection incidence and prevalence. In Kiribati, water and sanitation conditions improved modestly from 1990 to 2005. Water and Sanitation Figure 3.2 Open Defecation From 1990 to 2012: • Open defecation decreased 37% in 22 years, but 36% of the population continues with this practice 100 30 20 20 20 Rural Urban Total Rural 2011 2008 2005 2002 1999 1996 1993 2011 2008 2005 2002 1999 1996 1993 1990 Total Source: WHO‐UNICEF Joint Monitoring Programme, 2014 1990 0 0 51 40 36 20 0 Urban Source: WHO‐UNICEF Joint Monitoring Programme, 2014 Total Rural 2011 36 28 50 2008 44 67 2005 40 60 2002 40 49 57 1999 43 60 1996 52 87 80 75 1990 60 64 % Population 80 20 100 80 % Population % Population 100 40 Figure 3.3 Access to Improved Water Sources From 1990 to 20012: •Access to improved water sources increased by 35% during 22 years, but remain low, at 67%. •Disparities in access between urban and rural areas have remained almost unchanged; , only half of the rural population has access to improved water sources 1993 Figure 3.1 Access to Improved Sanitation From 1990 to 2012: • Access to improved sanitation increased 42% in 22 years, although just 40% of the total population has access • Disparities between rural and urban areas have decreased, but not significantly • 70% of people in rural areas do not have access to improved sanitation Urban Source: WHO‐UNICEF Joint Monitoring Programme, 2014 Food Safety Figure 3.4 Diarrhoea Management of Diarrhoea (Table 3.1) Zinc No Data Share of children under age 5 with diarrhoea receiving zinc treatment ‐ Existing policy framework Zinc Supplementation and Reformulated Oral Rehydration Salt in the Management of Diarrhea Source: Kiribati ‐ Food and Nutrition Security Profiles Food Utilization Nutrition and Health Figure 3.5 Exclusive Breastfeeding • Exclusive breastfeeding stood at 69% in 2009 and early initiation at 80 %, some of the highest rates in the region for these indicators Early initiation of breastfeeding Exclusive breast feeding rate (0‐5 months) 100 Figure 3.6 Complementary Feeding • Introduction of complementary feeding is timely for 68% of children • Complementary feeding practices deserve ongoing attention: 47% of children aged 6‐23 months do not meet the minimum meal frequency, 41% do not meet minimum dietary diversity, and 64% do not receive the minimum acceptable diet 80 Introduction of solid, semi‐solid or… 68 Percent 80 60 69 Minimum dietary diversity (breastfed… 40 Minimum meal frequency (breastfed… 20 Minimum acceptable diet (breastfed… 0 Percent 2009 Source: KIR_Kiribati Demographic and Health Survey 2009_2010 0 59 53 36 20 40 60 80 Source: KIR_Kiribati Demographic and Health Survey 2009_2010 Figure 3.7 Duration of Breastfeeding No Data Figure 3.8 Child Malnutrition and Poverty Micronutrient Status Figure 3.9 Vitamin A • Vitamin A deficiencies represents a severe public health concern (22% of pre‐schoolers) 100 Vitamin A Supplementation Coverage ‐ full – children 6‐59 months Percent 75 50 25 0 No Data 21.8 Vitamin A Deficiency (Pre‐School Aged Children) <0.7umoL /a 0 * VAD is a severe public health problem if >20% of preschool children (6‐71 months) have low serum retinol (<0.7µmol/L) Source: a/ WHO Global prevalence of vitamin A deficiency in population at risk 1995‐2005 report. Iodine (Table 3.2) Households consuming iodized salt ‐ Iodine deficiency (Urinary Iodine Concentration <100ug/L) among school‐age children ‐ *Optimal UIE 100 ‐ 199ug/L Source: Kiribati ‐ Food and Nutrition Security Profiles Policy Table ‐ 1 Enabling environment for Nutrition and Food security ‐ Policy documents addressing nutrition issues Nutrition related issues covered in these policies Maternal and Child Undernutrition Child undernutrition Low Birth Weight Maternal undernutrition Child obesity Obesity and diet related Adult obesity NCDs Diet related NCDs Infant and Young Child Source: Nutrition Covered Comments Breastfeeding Complementary feeding Int’l Code of Marketing of BMS Supplementation: Vitamin A children/women Vitamins and Minerals Underlying and contextual factors Iron Folate children/women Zinc children Other vitamins & min child/women Food fortification Food Safety Food security Food Aid Nutrition and Infection Gender Maternal leave Social Protection policies or legislation including food or nutrition component Kiribati ‐ Food and Nutrition Security Profiles Policy Table ‐ 2 Demographic Indicators (Table ‐ 5.1) Population size (thousands) /a Average annual population growth Year Economic Indicators (Table ‐ 5.3) Year 101 2012 GDP annual growth rate /c 2.8 % 2012 75375351 2012 GDP per capita (PPP) (constant 2011 international dollars) /c 1,772 2012 Gini index /c (100= complete inequality; 0= complete equality) ‐ ‐ ‐ ‐ Unemployment rate /c ‐ ‐ Population below US $ 1.25 (PPP) per day /c (%) ‐ ‐ ‐ ‐ Poorest 20% ‐ ‐ Richest 20% ‐ ‐ 44.07 % 2012 11 2012 ‐ ‐ 66 2012 71.4 2012 Agriculture population density(people/ ha of arable land /b) 0.7 2006‐2008 Employment in agriculture sector (% of total employment) /c 2.8 % 2000 Poverty gap ratio /e Women employed in agriculture sector (% of total female employment) /c) 1.1 % 2000 Income share held by households /c Proportion of population urbanised Number of children <5 years (thousand) Education level of mothers of under‐fives: None (%) Male Life expectancy at birth (Years) /a Female Adolescents (Table ‐ 5.2) Adolescent birth rate (number of births per 1,000 adolescent girls aged 15‐19) /a Adolescent girls aged 15‐19 currently married or in union /d Women aged 20‐24 who gave birth before age 18 /d (%) Year 39 2005 15.8 % 2005‐2012 9 Sources: a/ World Bank, Health Nutrition and Population Statistics Database 2014 Update b/ FAOSTAT 2013 Update; c/ World Bank, World Development Indicators Database, 2014 Update; d/ UNICEF, State of the World Children 2014 (data refer to the most recent year available during the period specified) 2008‐2012 The information inlcuded in this Food Security and Nutrition profile, is backed by recognized, validated and properlty published information available untill June 2014. Although updated information might be available at national level form different sources, until requirements of quality, validity and proper publication are met, it has not been inlcuded in this profile.